跟腱损伤的MRI分型与临床意义

MRI classification and clinical significance of the injuries of the Achilles Tendon

目的探讨跟腱损伤的MRI分型及临床意义。方法回顾性分析35例跟腱损伤的MRI表现与临床资料，根据跟腱损伤的病理改变，将跟腱损伤的MRI表现分为四型。结果（1）跟腱退行性变，跟腱增粗，前后径大于6mm，前缘凸起，前后缘不平行，T1WI、T2WI、抑脂序列跟腱内局灶性高信号。（2）跟腱周围炎，跟腱前脂肪垫中见斑片状长T1长他异常信号，跟腱周围出现半环状高信号，围绕跟腱后3／4。跟腱后、跟骨后滑液囊出现积液，跟骨内见骨髓水肿。（3）跟腱不完全断裂，跟腱连续性不全中断、跟腱纵行撕裂，跟腱内见纵行条状高信号。（4）跟腱完全断裂，跟腱连续性完全中断、断端呈锯齿状、杵状。结论MRI可确定跟腱损伤类型，对指导临床治疗非常有意义。

Objective To investigate the MRI classification and clinical significance of the injuries of the Achilles tendon. Methods The MRI and the medical records were analyzed retrospectively in 35 cases with the injuries of the Achilles tendon. The MR1 of the injuries of the Achilles tendon were divided into four groups based on pathology. Results （ 1 ） The Achilles tendon degeneration ： the Achilles tendon was thickened, its anteroposterior diameter 〉 6 ram, anterior convexity, an- terorpasterior margins no longer parallel, the focal hyperintensity in the Achilles tendon on T1WI, T2WI, Stir. （2） Various partterns peritendonitis ： the patch low - signal - intensity on T1WI, and high - signa - intensity on T2WI. Stir in the fat pad anterior to the achilles tendon, partially circumferential high signal sarrouding the teadon posterior 3/4, the fluid accumulation in the retro -calcaneal and tendon bursa, the marrow edema in the calcaneal. （3） Partial Achilles tendon tear, longitudinal tear： the continuity of the Achilles tendon was partial rupture, lon^tudinal continuity high signal intensity in the achilles ten- don. （4）Complete Achilles tendon tear： the continuity of the Achilles tendon was complete rupture, the tendon edgel was sawtoothing or dubbing. Conclusion The injury types of the Achilles tendon can be definited by MRI, these is very important for guiding clinical treatment.